膝关节单髁置换术胫骨假体不同后倾角的有限元分析
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上海理工大学 医疗器械与食品学院

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国家自然科学基金项目(面上项目,重点项目,重大项目)国家自然科学基金(11502146),上海市自然科学基金(15ZR1429600)


Finite element analysis of Unicompartmental Knee Arthroplasty in different back inclination Angle of tibial prosthesis
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Department of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China

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    摘要:

    摘要:目的 建立单髁置换术胫骨假体后倾3°和7°膝关节不同屈膝角度的三维有限元模型,研究两种后倾角膝关节内生物力学特性和假体磨损及其对功能的影响。 方法 结合人体膝关节CT与MRI图像和第三代牛津假体,建立胫骨假体后倾3°和7°情况下屈膝0°、30°、60°、90°和120°的单髁置换术有限元模型,在股骨内外侧髁中心点上施加1000N载荷模拟人体站立相负重,分析不同屈膝角度下单髁假体与关节软骨的最大应力及分布。 结果 膝关节五种屈膝角度下胫骨假体后倾3°和7°的研究表明,五种屈膝角度下半月板衬垫最大应力3°分别比7°增大了28.06%、68.99%、19.45%、21.06%、53.38%,分布区域从衬垫侧边向中央区域集中,屈膝120°时应力集中明显,数值有所减小,这是由于半月板衬垫与股骨假体末端接触近似于点接触导致;后倾3°时胫骨假体最大应力集中于内侧,随着屈膝角度增加应力从假体根部蔓延到表面,最大应力数值在0°-90°区间保持稳定,屈膝120°时增长较大,后倾7°的变化趋势相同但应力值均小;胫骨假体σ接触呈现锥形变化趋势,在屈膝0°、30°和60°时减小,在屈膝90°和120°增大;股骨软骨和胫骨软骨的σ接触在五种屈膝状态下,存在σ3°接触<σ7°接触。股骨软骨的接触应力在0°时最大,90°时最小,相差幅度分别为113.76%和10.22%。 结论 单髁假体所受应力会随胫骨假体后倾角、膝关节屈曲角度变化而产生变化,胫骨假体后倾3°单髁假体最大应力值均大于7°,应力集中区域的扩大会导致假体的磨损和松动,关节软骨接触应力和集中区域随后倾角增大而增大,在高屈曲角度时应力集中更明显,关节软骨较大的应力峰值会导致对侧间室关节炎的发生,研究结果可为临床膝关节单髁置换手术方案设计提供理论依据。

    Abstract:

    Abstract: objective To establish a three-dimensional finite element model of knee joint with different knee bending angles of 3° and 7° in the single condyle replacement of tibial prosthesis, and to study the biomechanical characteristics of knee joint with two kinds of posterior dip Angle, prosthesis wear and its effect on function. Methods combined with the human knee joint CT and MRI image and the third generation of Oxford prosthesis, establish the tibia prosthesis after pour 3 ° and 7 ° bend your knees 0 °, 30 °, 60 °, 90 ° and 120 ° of the finite element model of single condyle replacement, on the center of the lateral femoral condyle 1000 n load simulation of the human body stance phase load, analysis of different order condyle prosthesis knee Angle and maximum stress and distribution of articular cartilage. Results knee knees five angles pour 3 ° and 7 ° after tibial prosthesis research shows that maximum stress five knees angles meniscus pad 3 °, respectively, compared with 7 ° increased 28.06%, 68.99%, 19.45%, 21.06%, 53.38%, the distribution area from the gasket side to concentrate in the central area, 120 ° bend your knees when obvious stress concentration, less value, this is because the meniscus liner contact with the end of the femoral prosthesis is akin to point contact cause; The maximum stress of the tibial prosthesis was concentrated in the medial side when it was tilted 3° backward. As the bending Angle increased, the stress spread from the root of the prosthesis to the surface. The angular contact of the shin prosthetics is tapered, decreasing at 0°, 30° and 60° at the knees and increasing at 90° and 120° at the knees. For the femoral and tibial cartilages, there are three readings of the readings at five knees. The contact stress of femoral cartilage was the largest at 0° and the smallest at 90°, with the difference of 113.76% and 10.22%, respectively. Conclusion single condyle prosthesis by stress varies with Angle, knee flexion Angle changes after tibial prosthesis and produce change, tibial prosthesis pour 3 ° single condyle prosthesis after maximum stress value not less than 7 °, the stress concentration area enlargement lead to wear and prosthetic loosening, the contact stress of articular cartilage and concentrated area then dip Angle increases, the high stress concentration is more obvious when the buckling Angle, articular cartilage of the larger the peak stress will lead to the happening of the lateral compartment osteoarthritis, the results can provide clinical knee joint replacement surgery single condyle provides the theory basis for the design.

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  • 收稿日期:2020-05-21
  • 最后修改日期:2020-07-10
  • 录用日期:2020-07-16
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